Shortly after turning 21, my perception of myself got worse. I felt like I was truly a young adult and that my acne was only getting worse, not better.

My self-disgust was a big part of the reason that my long-term relationship ended last summer. I would get angry any time my girlfriend even touched my shoulder or something. I went on a diet of almost nothing but orange juice, almonds, and light beer. I exercised constantly, and I purged several times.

Unrelated, I began to grow distant from or untrusting of most of my friends around the same time. Everyone thinks that I was "depressed" because of the breakup, when it was the other way around. I failed a class fall semester in large part because I would often not go to class because I felt disgusting. I only look in the mirror when I shave. I feel physically uncomfortable anytime I'm around others. Just sitting in class racks my brain. I never interact with anyone more than I have to, because Sometimes I feel like if I did, it would be like that scene in the Elephant Man where he's in the train station and they pull off his cloak.

I have been seeing a therapist for 3 months, after my parents found something I wrote online about feeling suicidal in the summer. Only today did I first begin to speak of acne, because he suggested going on antidepressants or ADHD medication, and I said that I was worried that they would try to take me off of accutane. He was confused and said he didn't think I had any case of acne. We didn't really get into discussing it before time was up, but now I'm not sure if I want to go back.

I have been on accutane for 2 months and haven't seen any impact yet. My ex-girlfriend and my mother always said that I'm concentrating on it too much, that I don't have an acne problem, etc. I recognize that mine is not severe or nodular or anything, but it's mild-moderate and it's been resistant to everything I've been on. When my therapist and ex-girlfriend and mom say it's in my head, I feel even worse. I mean are they bullshitting me, or am I entirely delusional? I can feel the bumps. I can feel a new pimple come up. I know what it is when I cut myself shaving.

Why would the dermatologist agree to put me on accutane if it wasn't real?

All the latest toughs, youâ€™ve got to shrug them off or shut them off.[/size]

I've always wondered if I could be diagnosed with acne dysmorphia. I might be a strong candidate for it. I pick at my appearance and strongly critique every part of my body. I don't think your mom and ex-girlfriend are lying. It is in your head, just like it was in my head. I'm relatively clear now, and it is still in my head.

It's good that you're receiving help. I kind of wish I did. It would be nice to sit in front of a psychologist. I would love to see how they work, and what type of therapy they suggest for my situation.

I also think you should talk more about your acne to your therapist, Oh No My Nutrients. I believe that some of the people who says your skin is not that bad just want to make you feel better, although it always back fires and makes you feel worse about yourself.

Sometimes I wonder if I have BDD or is it all just reality and not imagination. One of the biggest reasons for why I have never seeked clinical help is that I fear that once I open up and tell them about my issues with my appearence they would say something like this: "You are perfectly sane, 'cause you really do look like shit. You can't really do much about that, so do you have any other problems you would like to discuss about?" Anyway, I can function normally in society, go to school and do stuff like that although I feel shitty as hell about my appearence all the time, so perhaps that means it isn't bad enough for me to seek clinical help for.

Thanks, I guess I'll keep going for at least a few more sessions and get it out... I really only ever begun to verbalize any of this at all with my then-girlfriend.

I just want to live life. I realized that it's barely been 6 weeks on Accutane, and a couple of people told me that seeing results by the end of 3 months is more typical than in 1 month so I've still got time to go. If anyone tried to take me off of it, I really don't know what I'd do.

In the meanwhile, my parents will continue to bother me about stuff like interviewing for internships while I have zero self-confidence. If I'm not somewhere that I absolutely have to be like class or work, I'm locked in my room all of the time, and I have spoken more than two words to one person on campus all semester.

All the latest toughs, youâ€™ve got to shrug them off or shut them off.[/size]

If you want to live life, it's waiting. Don't think you have to look a certain way. Staying locked up in a room will only fill your soul with regret. Chance has already been given to you. Now it is a matter of choice. You're clearly unhappy with your previous choices, so why not jump into the unknown gorge with the rest of us? Don't be afraid. Nobody makes it out alive anyway.

I think what's happening is that you do have mild-mod acne, like you say, but it looks a thousand times worse to you, which is totally natural, and also you may very well have acne dysmorphia. But you're mom and girlfriend are telling you it's better than it looks, because:

1. it looks a thousand times better to them than it does to you, because they see it how it really is, not as if it was on them

2. they love you. they want you to feel good, they want you to feel better

the result = it sounds like a big lie, and makes you feel stupid/crazy/annoyed.....etc

you KNOW it's there, because it is. the fact is, it's mild-mod, so it's not THAT bad- here are a few hometruths: It's probably nowhere near as perfect as you want it right now, that's the truth, what you have to accept alongside that, is that it doesn't make you ugly, or worthless, or less important , or anything like that. Acne is a battle and the sad fact is yes, your/my face did/will look better when it's gone, but it's not the end of the world. It's not necessarily your acne that has to change, but your perception of it, which is why I think it's really good you're in therapy. The reason you've been given accutane is because, like you say, your acne is persistant and hasn't responded to anything else. In recent years this is becoming the case more and more often, dermatologists are using accutane not only as a last resort for severe acne, but also for persistant cases of mild-mod, where nothing else has worked. As you know its the nuclear bomb of all acne medication, your derm has given it to you because you've tried other stuff and basically he just wants it to work.

I would highly recommend looking into acne dysmorphia, and maybe asking your therapist if you can do a few sessions on this- your outlook on your acne has effected your self-esteem so much and your relationship, I'd say now would be the right time to start dealing with these issues. Sometimes having a medical or psychological name to put on something can explain alot- it also gives you a good starting point to dealing with the issues that you're acne has given you.

Don't you want to be able to see yourself how your girlfriend and your mom see you? Maybe also in your spare time read a book on confidence or something to do with, if you fancy that.. confidence isn't something that some people 'just have' and others don't.. it's a set of skills that can be learnt by anyone, if you don't want to take the time to learn them, it's more a case of "Fake it till you make it!" Tht said.. don't force yourself into anything you're not ready for, too soon. But seriously with the therapy... remember it's his job to put you at ease so you feel you can open up, and if he's not working for you, you can always ask your parents to switch- but please, please open to him about your acne.

Good luck.

. . .Life is just a mirror, and what you see out there, you must first see inside of you. . .

It does sound like you might have body dysmorphia. By talking to your therapist about your acne and how it makes you feel will start to help.

I have been diagnosed with BDD. In early 2008 I woke up one day and saw myself differently. It was like my vision had cleared and I was looking at the "real" me. The past year has been horrific and I got to the point of suicide. I couldn't take it anymore so went to see a doctor who said I should see a therapist.

My therapist was speechless when I told her how I felt about myself. I don't have acne anymore just the occasionaly pimple. Unfortunately my skin is scarred and to me this is worse than the acne itself. I saw my therapist for 6 weeks and in a way it did help talking about my feelings. She would say I was pretty but I looked in the mirror and didn't see it. All I could see were scars. When she would say she couldn't see them I would want to scream at her!

I was referred to a pyschiatrist to be diagnosed for BDD. At this point (December 2008) I was put on anti-depressants to reduce the anxiety I was suffering from. I frequently had anxiety attacks due to the pure disgust I felt looking in the mirror. The tablets have reduced this anxiety which has made a huge difference.

I have also, in conjunction with the medication, been having CBT. This has been great. It has really helped me see myself better. I'm not 100% better and I will live with this condition for the rest of my life. It has taught me how I can break the cycle of negative feelings = anxiety = hating myself. At one point every day was a "bad day". On bad days I could barely function. I can't eat, I shut myself away and cry and cry and cry. I would say I only have "bad days" twice a month at the most. Don't get me wrong I am still very conscious of my skin and don't feel that pretty but I can cope with it and feel more like I used to.

Best of luck with the therapy and accutane, if you ever need to chat please message me.

Same problem here. When I've opened up to friends about my skin, they've told me I don't have bad skin at all. A couple wks ago I went to Macys to get some clinique products. The young girl there (perfect skin) tells me she loves the Clinique Pore Minimizer product too. I tell her my face is awful and breaks out all the time, and she tells me my skin looks good. (is she lying? Is she telling the truth? GRRRR).

Here's the thing with me though, and maybe some of you have the same issue: Some days I look good and some days I look horrible. I can look good in the morning and look bad by evening. My skin just seems to fluctuate so much. Sometimes my pores look huge, sometimes smaller. Sometimes my scars look really bad and blotchy, sometimes they look less noticable. And there are times when I go to meet a friend and I have fresh make up on and look presentable, and that's why I think they say I don't have a problem. But see me after 8 hrs of work or on a hot, humid day or after I just went swimming! (but I don't let them see me then. lol)

Alright, thanks, for the advice. I guess I'll at least go to my next appointment and talk about it. After reading that dysmorphia is akin to anorexia, it clicked for me. Maybe I should be seeing a therapist who specializes in eating disorders, I don't know, I'll see how things go this week.

In the meanwhile, yeah I don't know how to respond when my mom asks why I don't go for interviews, or go do this or that.

I feel like outside of people who already understand acne here, opening up about this stuff would be like exposing someone to some kind of dark-sided truth that cannot be unseen. And getting dumped around the same time I was just barely opening up about this shit to my girlfriend didn't help in terms of trusting others with it.

All the latest toughs, youâ€™ve got to shrug them off or shut them off.[/size]

I guess therapy is helping with pieces of it, for example, when people tell me I look young, I would always make the immediate connection that it's because I must be "some pimply teenager." Maybe I just in fact look young and there's nothing wrong with that.

But I feel like it's impossible to get rid of the feelings until I get rid of my acne, and I truly hate being myself for it, and these thoughts idunno it's like being possessed by something. It's even worse when I'm breaking out around my mouth, because it's like it silences me; it's like I'm too disgusting to speak and who would respect what I had to say anyway?

I can't ever focus on anything more than a week down the line, because I wish I could just go into a cocoon and emerge happy and without acne. I have no idea how to explain to my mom what a grueling hell it is just to live everyday.

And if they tried to take away the accutane because they think it's what's making me depressed (why do people not understand correlation vs. causation!?), or if it turns out to not work, I really, really don't know what I'll do.

All the latest toughs, youâ€™ve got to shrug them off or shut them off.[/size]

I am also diagnosed with BDD and have been in therapy for the last 8 years. However, I am at the point that I was able to stop seeing a therapist recently and am on minimal psych. medications now. I think Rachael mentioned the BIG piece of the puzzle for BDD and that is CBT: Cognitive Behavioral Therapy. BDD and OCD are very, very interrelated as well. Alot of times there is "crossover" between the two. CBT is a lifesaver for both. I'm so glad to hear you are getting help, and hope that you will continue to do so! There used to be a great website run by a girl with BDD named Emma. Unfortunately it doesn't seem to be up anymore, but if I can find it (maybe she's moved it?), I will let you know the web address.

I also think about my acne all the time. It doesn't make me feel ugly, but it makes me feel deformed in a sense. I know I am good-looking, even with the acne, but I feel like acne really shouldn't be on my face and that it being there is a sign of something wrong with me. I feel like the acne is a sign that somehow my immune system is not strong enough to get rid of it, and in that way it makes me less confident in my physical health.

I recently started looking at this website and have been at least temporarily addicted to browsing these pages. It is somewhat comforting to know others are having similar troubles with acne and I am not the only one. I had relatively clear skin until about 3 months ago. I was on antibiotics for an unrelated reason, and when I got off the antibiotics I developed some cystic acne on my face (I never had this kind of acne before). I've been trying to get this to go away first with just benzoyl then clindamycin also. For some reason just feel like this acne shouldn't be on my face, like its a foreign invader, and I want more than anything to get rid of it. It feels like all I have to do is get rid of it, and then my life will be perfect. This is kind of a strange feeling, because I know deep down that even if it does go away then I'll just find something else to be concerned about my appearance.

Today I was looking at a friend of mine (who is very pretty), and I just realized that she has worse acne than I do. But I never noticed in my life that she has acne until know (and I've known her for half a year), so it kind of startled me to realize how I don't really pay much attention to others acne. Could it be that others don't pay any attention to my acne? Well I hope so. But I nonetheless that thought is not completely comforting. I still feel that I need to get rid of the acne to get my confidence back, no matter how much I understand it is silly to feel that way it is still hard to cancel those thoughts.